Preterm delivery, defined as birth occurring prior to 37 completed weeks'gestation, complicates 12-13% of all births in the United States. For reasons that are largely unknown, the rate of preterm delivery has increased during the past few decades. Preterm delivery is not only a leading cause of neonatal morbidity and mortality but also has long-term sequelae for the offspring. Limited data suggest that there is also consequences for the mother - factors related to cardiovascular risk may increase the rate of preterm delivery during the mother's reproductive life and cardiovascular morbidity and mortality in the mother's later life. Whether or not the association is replicable and persistent is unclear and the nature of the underlying mechanism (s) is not understood. We propose to conduct a nested case-control study to examine whether several major cardiovascular disease (CVD) risk factors (hyperlipidemia, biomarkers of inflammation and endothelial dysfunction) are associated with an increased risk of preterm delivery and whether abnormal levels of CVD risk factors persist at 6 weeks postpartum. We will compare all measurements from cases (women who delivered preterm) to controls (randomly selected from among women who delivered at term) between early and late pregnancy and postpartum. We will use already collected data and specimens (fasting blood samples collected at entry to care (<20 weeks), week 28 gestation and 6 weeks postpartum) in our prospective studies of low income, minority women from Camden New Jersey (N=2,816 enrolled 1996-2006). We hypothesize that in comparison to controls: 1). Biomarkers for CVD risk are elevated in the cases either early in gestation or become elevated later in pregnancy;2). Biomarkers for CVD risk remain elevated in cases during the postpartum. Our data have the potential to provide important insight into the mechanisms underlying preterm delivery and later CVD risk in women who deliver preterm. Our long term goal is to determine if women who delivered preterm have eventual evidence of CVD risk or CVD events by following Camden study participants who delivered 2-25 years ago. Thus, this research has important implications for child health and for women's health during the reproductive and the mature years. PUBLIC HEALTH RELEVANCE: Infants born preterm are at high risk of infant death and of serious complications that carry a high cost to society. Women with a history of preterm delivery may also be at risk of cardiovascular disease (CVD) in later life. Preterm delivery and/or later CVD may be preventable by screening for CVD risk factors, many of which (e.g. high lipid levels) are potentially modifiable before, during or after pregnancy.